Nursing Assessment for Post-Angioplasty Care

Assessment is a key component of nursing practice, required for planning and provision of patient and family centred care. The Nursing and Midwifery Board of Australia (NMBA) in the national competency standard for registered nurses states that, “The registered nurse assesses, plans, implements and evaluates nursing care in collaboration with individuals and the multidisciplinary health care team so as to achieve goals and health outcomes.”

The simulation scenario involved Mr Bright who had just undergone an angioplasty. A potential problem related to this procedure includes impaired tissue perfusion related to haematoma formation or bleeding.

You are required to find two (2) contemporary, valid research articles (no older than 7 years) relating to the care of the patient undergoing angioplasty. Read the articles focusing on the assessment elements of care required post procedure. (Don’t forget to link your assessment reasoning to anatomy and physiology and pathophysiology). ï‚· Reflecting on the simulation, you are required to identify CORRECT nursing assessment performed on Mr Bright relating to the problem stated above. Justify your discussion using evidence from your researched articles.

Reflecting on the simulation, you are now required to identify those elements of nursing assessment that were NOT performed on Mr Bright relating to the problem stated above. Justify your discussion using evidence from your researched articles.

National Safety and Quality Health Service Standards for Clinical Handover recommend that communication of patient information should be conducted in a standardised format using a structured process in order to transfer relevant patient information.

In the simulation, ISBAR was the structured format used to communicate patient information. 

ï‚· Reflect on the simulation at the point in time when Mr Bright complained of chest pain. Using the ISBAR format, dot point your structured verbal handover to the doctor advising of the patient’s chest pain. (You will need to access the patient’s clinical documentation available on Blackboard to complete all areas of ISBAR). As chest pain is an emergency situation, the information provided in  ISBAR needs to be concise.

The Importance of Assessment in Nursing Practice

Bright is a patient who is receiving post-angioplasty care. During his post operative care, the patient should be adequately monitored and provided with all the necessary support that he deserves. When attending to him, I had to do my best to ensure that he manages his condition well.  In this section, I would like to reflect on the strengths and weaknesses of the assessment that was done on the patient.

The patient was provided with appropriate post angioplasty care that would enable him to manage his conditions. Just like any other patient, Bright was observed to be experiencing post angioplasty complications including bleeding and haematoma formation­-related chest pain. According to the research conducted by Arokiaraj, Guerrero, Levine & Palacios (2013), the patient was to be given a good care commensurate with the condition.  Post angioplasty care was to be effectively delivered because it was necessary for improving the condition of the patient. So, to achieve this, we had to be actively involved in assessing the patient to determine the condition and identify the most appropriate intervention to provide (Chai-Adisaksopha, Crowther, Isayama & Lim, 2014). 

During the assessment exercises, I managed to successfully monitor the patient’s vital signs. I had to apply all the principles, policies, and guidelines governing postoperative care to help me in the monitoring of the patient’s vital signs. This was a commendable thing to do because all post angioplasty patients have certain signs that should be taken so seriously. It is at this stage that the patient can experience challenges like bleeding (Chai-Adisaksopha, Crowther, Isayama & Lim, 2014). Therefore, all the vital signs must be rigorously monitored, observed and recorded throughout. I successfully did this because I knew the reason why it had to be done. At the same time, I managed to successfully check the patient’s sight and managed his IVT and infusion because it was one of the activities that I was supposed to carry out. If I had failed to do so, I would not have managed to display my competence as a postoperative nurse.

 The other thing that was rightfully done during the assessment process is a strict compliance with the PQRST            process of patient assessment. Here, I had to assess the patient’s pain by considering the Provokes (causes of the pain); Quality (the sharpness, burning, dullness or crushing of the pain); Radiates (localization and radiation of the pain); Severity (the 1-10 scale for the severity of the pain); and Time (the beginning, and duration of the pain). The application of the PQRST method was good because it enabled me to assess and be acquainted with finer details of the pain. In fact, I had to dig deeper into the historical background to determine exactly when the pain began, its severity, and the entire duration it has taken.

Last, but not least, I did an excellent job by adopting a multidisciplinary approach during my assessment. As a professional, I believe in the power of teamwork. I am a team player who always works alongside other experts.